It’s just been publicly announced that the vitamin pill magnate Matthias Rath has pulled out of his gruelling legal case against me and the Guardian. He bought full page adverts denouncing Aids drugs while promoting his vitamin pills in South Africa, a country where hundreds of thousands die every year from Aids under an HIV denialist president and the population is ripe for miracle cures. I said his actions were highly worrying, in no uncertain terms. I believe I was right to do so.

This libel case has drawn on for over a year, with the writ hanging both in my toilet, and over my head. Although fighting it has been fascinating, and in many respects a great pleasure, it has also taken a phenomenal amount of my time, entirely unpaid, to deal with it. For the duration of the case I have also been silenced on the serious issues that Rath’s activities raise, the chapter on his work was pulled from my book, and I have been unable to comment on his further movements around the world.

This will now change, and I hope that other newspapers will have the sense to step outside of commercial allegiances and write about his activities, despite this single incident being one newspaper’s tussle. I genuinely believe that the madness of the South African government’s approach to Aids is one of the most important stories of our time.

Usefully, it seems that Rath will now be responsible for the Guardian’s legal costs. Interim costs were awarded this afternoon at just shy of a quarter of a million, and we are seeking the full half a million pounds the paper has spent. For my part, I will probably now write a swift book on Rath and South Africa, as a way to make all the fascinating extra information I’ve had to dredge through useful to others, and to try and recoup something so that my time was not wasted. It will be meticulously well referenced and carefully written.

I trust that this episode will act as a very strong cautionary note to the more vicious UK figures from the very corporate $50bn food supplement industry some of whom have used bullying, smears, and legal threats in their desperate bid to prevent people from examining their ideas: this goes to the very top of the industry, you should know by now that it will not work, and unless you change tack rapidly, some of you will have some very interesting surprises to come. Play nicely now, they’re only ideas.

I should also mention that I am extremely pleased and – cheesily – proud that the Guardian fought this case. It’s exactly the kind of thing I’d have expected from them, it’s the paper my grandparents bought, blah blah blah, and to me today everything they stand for is still very good indeed. I don’t think many other papers would tolerate a column as childish and wilfully geeky as mine, and for all the hassle, in a funny twist of reputation judo, the various corporate complaints about my work over the past few years have done me a world of good. I was just some nerd who emailed in a column once a week, but once I was being chased by millionaires it was lagers with the bosses. The editor txted me the other day. To me that is some slightly weird shit.

So, more to follow no doubt, but here is my comment piece for tomorrow’s paper, and below that, links to the triumphant Guardian coverage. I recommend buying the paper on Saturday just so that you can stroke it and reward their valour. It’s good on Saturdays anyway, and the leader is particularly excellent. Newspapers can be very good things, and today the Guardian is a very good one indeed.

With their money, myopia and abuses, these pill makers match big pharma

The food supplement industry likes to style itself as people’s medicine, but the way it stifles debate is far from democratic

Ben Goldacre
guardian.co.uk,
Friday September 12 2008 19:00 BST
Matthias Rath today pulled out of a legal case against the Guardian which has cost the organisation £500,000 to defend. I am proud that we fought it. Rath is an example of the worst excesses of the alternative therapy industry; UK nutritionists make foolish claims on poor evidence – they can make your child a genius with fish oils, or prevent heart attacks in the distant future – but Rath transplanted these practices into the world of HIV/Aids, where evidence really matters.

The potential consequences of his actions are outrageous, but he is by no means untypical. This sector has engineered a beneficent public image for itself, a warm and friendly cottage industry; but that fantasy is not borne out by the facts.

First, despite claims about the true evils of “big pharma”, presented as if they were evidence that vitamin pills are effective, there is little difference between the vitamin and pharmaceutical industries. Key players in both include multinationals such as Roche and Aventis; BioCare, the vitamin pill producer that media nutritionist Patrick Holford works for, is part-owned by Elder Pharmaceuticals, and so on.

The food supplement market, comprising products like vitamin pills and herbal supplements, is worth $50bn worldwide (against $600bn for pharmaceuticals). It has lobbied angrily and successfully against safety regulation, and the vitamin industry is also legendary in the world of economics as the setting of the most outrageous price-fixing cartel ever documented: during the 1990s the main offenders pleaded guilty and had to pay $1.5bn, the largest criminal fine levied in legal history.

That’s quite some cottage industry, and it is tightly linked to the “nutritional therapists” community. Bant, their UK membership organisation, recently changed its code of conduct in accordance with the wishes of pill manufacturers, so that members can now take undisclosed financial kickbacks for the pills they prescribe to patients. Doctors are struck off the GMC register for this activity, and rightly so.

Last year I went to a public meeting hosted by Matthias Rath in east London. He spoke for three gruelling hours, and every time he mentioned the side-effects of a treatment prescribed by doctors, the people in the seats behind me growled the word “murderers” in a venomous tone. Their hatred was intense, and it was unnerving to sit near them.

How do people become so extreme in their views? How have they been isolated from the realities of the miracle cure industries? A combination of wishful thinking, successful PR, and legal muscle.

When I attempted simply to write that the Dore miracle cure for dyslexia had not cured three people, we received several legal warning letters, delaying the piece by a month. An academic who dared to criticise the evidence base for the programme received a threatening legal letter delivered by hand to her home address.

Gillian McKeith has made repeated legal threats against websites who have dared to discuss her work, and her lawyer husband has threatened an academic who suggested testing her ideas. She also has a legal case hanging over the Sun that has seen little movement in three years.

When chiropractors had their practices challenged in the New Zealand Medical Journal they simply sent a threatening legal letter (“Let’s hear your evidence,” said the editorial in response, “not your legal muscle”). A herbal pill entrepreneur – and academic – had Professor David Colquhoun’s website removed from UCL servers after he dared to question her evidence. The Society of Homeopaths had a blogger silenced by threatening his web host.

I could go on. And of course, deterring dissent goes wider than the use of libel law. There is also the bizarre smear operation against critics of the food supplement industry, and an elaborate campaign conducted by homeopaths against Professor Edzard Ernst, an academic who has simply dared to examine the evidence for their claims, which ended up with his employers at Exeter University being harassed to silence him.

Meanwhile the alternative therapists who run university BSc courses refuse to release their lecture notes, or let anyone see their exam papers, in a desperate attempt not to engage with critical appraisal from the worlds of scientific evidence of which they purport to be a part.

This is not just unpleasant, it is also unhealthy. Ideas improve when they are challenged and questioned. I am a doctor, journalist and academic. I criticise the activities of doctors, journalists and academics in each of my jobs, and I welcome other people criticising my ideas.

Nothing could be more anti-democratic or stifling to debate than using money, law and power to regulate what can be discussed, and yet those who do it have the gall to represent themselves as the outsider, the little man, concerned with the medicine of the people. In reality they behave like nothing more than commercial entities.

The food supplement pill industry is phenomenally powerful, extremely lucrative and incredibly influential, but it has shown itself to be philosophically and commercially incapable of critical self-appraisal. Rath is its product. It is inconceivable that any individual within that industry would be brave enough to stand up and criticise his activities – and for that, more than anything else, it should be condemned.

Ben Goldacre, a medical doctor and author of the book Bad Science, writes the Bad Science column in the Guardianbad.science@guardian.co.uk

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If you like what I do, and you want me to do more, you can: buy my books Bad Science and Bad Pharma, give them to your friends, put them on your reading list, employ me to do a talk, or tweet this article to your friends. Thanks!
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gnome said,

More good news – South Africa’s new president has moved the erstwhile health minister, Manto Thshabalala-Msimang, out of the health ministry and given her a new portfolio (minister in the office of the president) where she can safely rant about beetroot and garlic to her heart’s content without doing too much harm. Three cheers for Barbara Hogan the new health minister – can’t wait to finally see some sensible government policies regarding HIV.
Ben – if you haven’t already done so you might want to read Jonny Steinberg’s “Three letter plague” – its a brilliant investigation of the limits of SA’s AIDS treatment program – definitely one of the best books I’ve read this year.

kitt said,

I’m not “middle class”, I’m not as they would say “educated” and I don’t read newspapers.

I have been diagnosed positive and have been “living with it” for eight years.

I was told recently that I had to start to take the medication otherwise I faced a long, slow, painful and miserable death.

I informed them I was worried about the side effects, as all medications (since birth) have disagreed with me.

You know the small print, the bit that says “very unlikely”, well with me I get it every time!

So they told me not to read it and just take them and I’d be ok.

Why then do some of the side effects say (unlikely but) can result in death, failure of organs etc?

Now am i stupid or can anyone tell me why anyone would want to take a pill that says a possible side effect is death?

In the beginning, when I was first diagnosed they told me they wanted me to stay off meds for as long as possible. Then out of the blue the goal posts changed and they said I would need to start when my count go to a certain level. Then the goal posts changed again and I was told, people need to start taking them as soon as they found out regardless of the count.

Sounds like bad science to me!

For personal reasons I have never been able to trust the medical profession and have always viewed them with suspicion.

I was given anti-biotics last year and was told I needed to take them until my count improved or more likely, when I started the hiv treatment.

I went away and said ok but I never took the anti-biotics.

My results this time had gone from less than 190 to almost 400.
I was told to stop taking the anti-biotics. The doctor asked me if I had decided to take the hiv drugs because of such an improvmnet. I told her I hadn’t started the hiv treatment.

She seemed shocked.

So to a degree I believe hiv drugs are not the answer to the problem. I almost believe in the hiv myth. I believe there are other issues causing the African problem other than hiv. I don’t agree that someone tried to improve sales of vitamins in the way it was carried out.

I know I am very much alone in these beliefs and I may be very much mistaken. It’s a chance I have to take. I’ll die with the drugs and I’ll die without them. We all will one day in any case!

The way the world is going at the moment, it may be better out of the picture!

Now moving on to another subject.

Can you please tell me why the Guardian did not report the homophobic murder of Michael Causer?

mare said,

I am not a supporter!
I was in fact rather innocently looking for a member of BANT to advise me!! This is because I am currently taking vitamin and mineral supplementation of my own election and wish to ensure that I will be balancing calcium and magnesium correctly …among other elements. I am aware that in the medical profession we have no adequate nutrition training and that this is a serious shortfall to our respective competencies.

I was distressed to read that you attended a public meeting about the issues of inappropriate medical treatment…without having apparently any inkling of understanding about how the public view us in the medical profession. I trained as a nurse and was dating a med student. One of the first thing both streams of training teach is the fact that we are the primary killers of the patient. I am sure you remember that?

Things have gone from bad to worse in our ability to knock people off. !!!!!!!!!!!!

Have no idea if you will receive this so rather than discuss further I’ll wait to see if a reasonable dialogue ensues as I would seriously like to clip your wings if you are looking to clip wings without self-clipping !!!!!!!!! I also do not understand your abbreviations.

With best wishes
Yours sincerely
mary
full name can be supplied

Jonathan said,

How has no one gotten rid of this guy?!?!? I am Furious that he has exploited these impoverished & suffering patients. I am shocked & saddened people like this can spread their falsehoods around and ruin so many lives!